Factors affecting the interrelationship between cynical hostility and dental anxiety among dental patients

Objectives: The objectives of this study were to assess the relationship between dental anxiety and cynical hostility in a sample of dental patients and to study the possible role of socioeconomic status (SES) in this relationship. Materials and Methods: A total of 288 dental patients completed a self-administered questionnaire consisting of the cynical distrust scale (CDS) and the modified dental anxiety scale (MDAS). Data on sociodemographic characteristics were also collected. Results: Dental anxiety as reflected by mean MDAS scores was significantly higher among the younger age group (P = 0.002), among females (P = 0.025), and the lower SES groups (P = 0.001). Cynical hostility was significantly higher among the older age group (P = 0.03), among males (P = 0.02), and among the lower SES groups, respectively, (P = 0.001). When the CDS scores for individuals with and without dental anxiety were compared within the context of the three socioeconomic strata, there was a statistically significant difference (P = 0.029) in scores between the two anxiety groups in the middle socioeconomic strata where the cynical distrust scores were lower among the anxiety group. Discussion: Mediation analysis revealed that SES played an important role in the association between dental anxiety and cynical hostility. It also showed that the mediating effect is not uniform across socioeconomic strata and may be different in different societies with their own unique population structures and classes.